Last November, I received an invitation to represent the European Society of Medical Oncology, speaking at the Japanese Society of Medical Oncology in Kyoto in July 2019. My first thought was “what a great opportunity”, my second was “I think that is graduation season” and my third (slightly belated) thought was I was expected at a long planned family wedding on the final day of the symposium. So having established that a) Medicine graduation would be on Monday 22 July, b) the organisers would schedule my session on day 1 of the symposium and c) there was a flight back that arrived at Heathrow at 6.30am on the morning of the wedding(!), I agreed to make the trip to speak about “Uses of genetic testing for cancer prevention”.
So, as I sit in Kyoto ready to give my talk in the next session, I am already looking forward to congratulating our students as they graduate and go forward into their future careers. At my own graduation, I was looking forward to starting my house jobs and to a summer break in Israel but I never imagined for a moment where my career in medicine would take me, except that I planned being based in hospital medicine rather than primary care (although I expect I would also have enjoyed primary care). When I was a student, I briefly thought about an intercalated year but I was in a hurry to get through the course and start the job so I chose not to, I wasn’t considering an academic career.
After house jobs in Manchester and core general medical training in Edinburgh, I spent a year of specialist training in haematology and a year in paediatric oncology before focusing on medical oncology which was when I really started to consider a career in academic medicine. I was involved in clinical trials, writing papers and was given the opportunity to undertake lab research in the MRC Human Genetics Unit just at the point that inherited cancer susceptibility genes were beginning to be identified and the potential for using these for cancer prevention became clear. My research has focused broadly in this area ever since. My initial consultant role was fully NHS funded but all my research was so relevant to clinical management in an emerging area of clinical specialisation (cancer genetics) that it worked well and our NHS department continues to be very strong contributors to the research agenda in clinical genetics.
I still enjoy seeing patients, though my clinical activity has been much curtailed since becoming Dean. I still enjoy research, although I rely even more on excellent collaborators and post graduate students! So for all our medical graduates next week, congratulations, you have chosen well, negotiated some of the biggest hurdles and now you can dare to dream.